FACTORS RELATED TO BREAST CANCER AMONG WOMEN IN YOGYAKARTA CITY PUBLIC HOSPITAL, INDONESIA - Repository Poltekkesjogja
PROCEEDING BOOK
THE 4 th
INTERNATIONAL CONFERENCE
ON HEALTH SCIENCE 2017
“The Optimalization of Adolescent Health in The
Era of SDGs”
INNA GARUDA HOTEL YOGYAKARTA,
INDONESIA
th
November 5 , 2017
HEALTH POLYTECHNIC OF HEALTH MINISTRY YOGYAKARTA Jl. Tata Bumi No.3, Banyuraden, Gamping, Sleman, Yogyakarta, Indonesia 55293 Phone/Fax.62-274- 617601,PROCEEDING BOOK
th THE 4
INTERNATIONAL CONFERENCE
ON HEALTH SCIENCE 2017
“The Optimalization of Adolescent Health in The Era of
SDGs”
INNA GARUDA HOTEL YOGYAKARTA,
INDONESIA
th
November 5 , 2017
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No part of publication may be reproduced in any methods without
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ISBN : 978-602-73585-1-5
Published by Health Polytechnic of Ministry of Health inYogyakarta 2017
PROCEEDING BOOK
th Proceeding of The 4
th
(Health Polytechnic of Health Ministry Yogyakarta, Indonesia)
S.Kep.,M.Kep,Sp.Kep.J Muryoto, SKM.,M.Kes
S.SiT,S.Pd.,M.Kes Ns. Sutejo,
Siti Nuryani, S.Si.,M.Sc Niken Meilani,
Dr. Ir. I Made Alit Gunawan, M.Si Dr. drg. Quroti Ayun, M.Kes
Sabar Santoso, S.Pd.,APP.,M.Kes Dr. drg. Wiworo Haryani,M.Kes
Editors:
(Health Polytechnic of Health Ministry Yogyakarta, Indonesia)
Muji Rahayu, S.Si.,Apt.,M.Sc
(Health Polytechnic of Health Ministry Yogyakarta, Indonesia)
Dr. Catur Budi Susilo, S.Pd.,S.Kp.,M.Kes
(Health Polytechnic of Health Ministry Yogyakarta, Indonesia)
Dr. Jenita DT Donsu, SKM.,M.Si
Dr. Yuni Kusmiyati, SST.,M.PH
(Health Polytechnic of Health Ministry Yogyakarta, Indonesia)
Nugraheni Tri Lestari, SKM, MPH
International Conference on Health Science 2017
(Health Polytechnic of Health Ministry Yogyakarta, Indonesia)
Th. Ninuk Sri Hartini, Ph.D
(National University of Singapore)
Dr. Shefaly Shorey
(Kenya Medical Training College Chuka Campus)
Reviewer:
Sammy Onyapidi Barasa, BSN,MPH
Dina Fadhilah, S.Tr
Apriyatni Condro Ekarini, S.ST.,M.Kes Andika Trisurini, S.Pd Ayu Triani, S.T.
Members:
Sabar Santoso, S.Pd.,APP.,M.Kes
Editorial Board for
Proceeding Chief:
November 2017
Printed in Yogyakarta
“The Optimalization of Adolescent Health in The Era of SDGs”
PROCEEDING BOOK The 4 th International Conference On Health Science 2017 iii
Table of Contents
...............................................................
Page Address from The Chairman of The Conference viii
.........................Address from Director of Health Polytechnic of Health Ministry Yogyakarta ix
xThe 4th International Conference On Health Science 2017 Committee ............................
........................................................................................................................ xviList of Keynote Speaker
List of Oral Presentation ............................................................................................... xvii
................................................................................................................ xixList of Poster Presentation .............................................................................................
................................................................................................................ 1 Abstract of Keynote Speakers Full text of Oral Presentation ............................................................................................................
10 142 Full text of Poster resentation
Keynote Speaker I-01 Role of Regional Head in Order to Successful Community Movement Health Living on Adolescent ..........................................................................
Dra. Hj. Sri Muslimatun, M.Kes (Indonesia)
1 I-02 Health Ministry’s Policy to Improve Adolescent Health in The Era of SDGs ................................................................................ drg. Usman Sumantri, M.Sc (Indonesia)
2 Climate Change and The Health Consequences in The Population I-03 ..................................................
3 Prof. Dr. Tengku Mohammad Ariff R. Husein (Malaysia) I-04 Overview for The Policy and Support of Government of Thailand ............................................
4 Prof Assoc. Prof. Patcharee Jearanaikoon, PhD (Thailand) I-05 HIV Testing in Laboratory and Community to Detect Carrier Among Adolescence Immediately ....................................................
5 Assistant Prof. Amonrat Jumnainsong, PhD (Thailand) I-06 Mental Health Detection in Teenagers ................................................................................
Ns. Sutejo, M.Kep,Sp.Kep.J (Indonesia)
6 Youth Marriage on Reproductive Health I-07 ...........................................................................
Dr. Yuni Kusmiyati, SST.,MPH (Indonesia)
7 Hormonal Changes in Tissue Periodontium in Adolescents I-08 .....................................................
8 Dr. drg. Dahlia Herawati, SU.,Sp.Perio (K) (Indonesia) I-09 Improving Child Nutrition Literacy For Teenage Pregnant Women And Its
Implication To The First 1000 Days Of Child Life: Arguments For
Developing Social Media Based Adolescent Support Group In Indonesia
.................................................................Dr Dr. Mubasysyir Hasan Basri, MA (Indonesia)
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Oral Presentation O-01 Identifying the Role of Hemoglobin in Intradialytic Nausea and Vomiting in Panembahan Senopati General Hospital in Bantul ...............................
10 Cornelia D.Y Nekada, Eva Ernawati, Tia Amestiasih (Indonesia) O-02 The Influence Of Early Breastfeeding Initiation On Postpartum Mother's
Breast Milk Production In Lismarini Independent Midwifery Pratice
Palembang ...................................................................18 Indah Rahmadaniah, Lusi Meliani (Indonesia) O-03 Maternal Characteristics and Low Birth Weight ..............................................
22 Tri Budi Winarsih, Hesty Widyasih, Margono (Indonesia) O-04 Relationship of Obesity Early Pregnancy With Preeclampsia In RSUD Sleman 2016 ...............................
Della Eprilian Sari, Dyah Noviawati Setya , Margono (Indonesia)
30 O-05 The Effectiveness of Nipple Stimulation By Providing Supplementary
Food to Succesfull Breastfeeding Back (Relactation) To The
Breastfeeding Mothers In Southern Tangerang 2016 .............................................................................................................35 Isroni Astuti (Indonesia) O-06 Factors Related to Breast Cancer Among Women in Yogyakarta City Public Hospital, Indonesia .................................
Tia Arsittasari, Dwiana Estiwidani, Nanik Setiyawati (Indonesia)
43 O-07 The Effectiveness of Health Education Through Smartphone and Booklet on Knowledge and Attitude of Adolesence Reproductive Health Puspa Sari, Kusnandi Rusmil, Arief S. Kartasasmita, Farid, Tati Latifah Erawati ............................................. Rajab, Deni K. Sunjaya, Tina Dewi Judistiani (Indonesia)
51 O-08 Physical Activities and Snack Consumptions of Obese Adolescents In Bantul, Yogyakarta ..............................................................................................
60 Mellia Silvy Irdianty (Indonesia) O-09 The Correlation Education About Health Reproductive and Knowledge and Attitude of Health Reproductive of Adolescent .......................................................................................
68 Kusbaryanto , Hatasari (Indonesia) O-10 The Relationship Between Knowledge,Attitudes, Actions Related to The
Clean and Healthy Behavior and Nutritional Status with Diarrhea Events
In Islamic Boarding School .............................74 Sinta Mukti Permatasari, Ayu Rahadiyanti, Fathimahi (Indonesia) Working O-11 Factors Associated with Exclusive Breastfeeding among Mothers in Yogyakarta City, Indonesia .....................................
Sri Yunita, Munica Rita Hernayanti, NikenMeilani (Indonesia)
79 O-12 Characteristics of Sexually Transmitted Infections In Polyclinic dr.Sardjito Hospital Yogyakarta ...............................
86 Atika Karunia Zulfa, Jenita Doli Tine Donsu, Sugeng (Indonesia) PROCEEDING BOOK th
The 4 International Conference On Health Science 2017 v
O-13 Factors That Influences of People Living With HIV/AIDS (PLWHA) in
VCT Division of General Hospital Waluyo Jati Kraksaan District
Probolinggo ...................................................................95 Cicilia Windiyaningsih, Iis Hanifah (Indonesia) O-14 Advanted of Sarang Semut Infusion (Myrmecodia Pendens Merr & Perry) as Decreased Blood’s Uric Acid in Male Rats of Wistar Strain ...........................................................................
Agus Suprijono, Ariani Hesti (Indonesia) 102 O-15 The Meaning and Role of Spirituality in HIV/AIDS Patients .......................................................
Agus Prasetyo, Sodikin, Widyoningsih (Indonesia) 107 O-16 Therapeutic Communications Reduce The Patient's Anxiety of Pre Operation Patiens ............................................................
111 Intan Mirantia, Harmilah, Surantana (Indonesia)
O-17 Analysis of Related Factors with A Subjective Complaint of Musculo Relationship Skeletal Diseases (Part II) : Characteristics and Characteristics Individual Factors on Workers Insurance Office .................................................
117 Arif Jauhari, Kuat Prabowo, Arfia Fridianti (Indonesia)
O-
18 Effects of Husband’s Support in The Duration of Second Stage of Labor Among Primigravida in Indonesia ..............................................................
124 Sagita Darma Sari, Desi Ratnasari (Indonesia)
O-19 The Relationship Between Family Burden with Frequency of Recurrence Patient with Paranoid Schizophrenia ..........................................................................
Livana PH, M Fatkhul Mubin (Indonesia) 129 O-20 Information Through The Flipbook to The Level of Knowledge About Domestic Violence in Fertile Couples in Sleman in 2017
Yani Widyastuti, Khadizah Haji Abdul Mumin, Yuliantisari (Brunai Darussalam) 135 Poster Presentation P-01 Experience of Adolescents with Premenstrual Syndrome and
Information-Focused Therapy (IFT) For Reducing Its Affective
Symptoms ................................................................142 Dewi Marfuah, Nunung Nurhayati (Indonesia)
P-02 Correlation of Amount of Parity and Menopause Age in Padukuhan Cangkringan, Argomulyo Village, Cangkringan District, Sleman Regency, Special Region of Yogyakarta .........................................................................
152 Ninyng Nurdianti, Sukmawati (Indonesia)
P-03 The Risk of Obesity and Developmental Delay in 2-5 Year Old Stunted Children in Kanigoro, Saptosari, Gunung Kidul, Yogyakarta .........................................................
158 Rr Dewi Ngaisyah, Siti Wahyuningsih (Indonesia)
Giving of Catfish Abon to the Creatinine Level of Haemodialysis Patients
P-04 .........................................................163 Fery Lusviana Widiany , Ari Tri Astuti (Indonesia)
Effect of Moringa Oleifera Cookies in Anemia Adolescent P-05 .....................................................
167 Devillya Puspita Dewi, Farissa Fatimah (Indonesia)
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Experiences of Drug Users In IIA Class Jail Yogyakarta P-06 ....................................................................
Sri Hendarsih, Wisnu Sadhana (Indonesia) 171 P-07 A Social Ecological Perspective on The Indonesian Maternal Mortality Problem; An Annotated Bibiliography ....................................................................................................
Inraini Fitria Syah (USA) .. 177
The Importance of Assistance to Cancer Patients with Mental Disorders P-08 ..................................
183 Muhammad Raftaz Kayani, Jenita Doli Tine Donsu (Pakistan)
Larvicidal Activity of Star Fruit Extract (Averhoa carambola linn) Against
P-09 Larvae of Aedes aegypti ........................................................................................186 Siti Zainatun Wasilah (Indonesia)
Factors Related to Decision Making Choosing Place of Delivery In Fakfak
P-10 District West Papua Year 2017 ...................................................193 Bernadet Dewi Kusuma Harimurti Kunde (Indonesia)
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The 4 International Conference On Health Science 2017 vii
th The 4 International Conference on Health Science 2017 Committee
A. Steering Committee
Advisory Committee : 1.The Head of Health Practitioners Training and
Education Center of The Committee on Development and Empowerment of Health Human Resources of Health Ministry of Indonesia
2.The Head of Committee on Development and Empowerment of Health Human Resources of Health Ministry of Indonesia
3. Dr. Robert Priharjo, M.Sc, BSN PGCE RN Lecturer Anglia Ruskin University, United Kingdom B. Organising Committe
Person in charge : Joko Susilo, SKM.,M.Kes Chairman I : Sari Hastuti, S.SiT, MPH Chairman II : Mohamad Mirza Fauzie, S.SiT.,M.Kes Chairman III : Sri Arini Winarti Rinawati, SKM, M.Kep Secretary : Yani Widyastuti, SSiT, M.Keb Treasurer : Suwandi, SE
Tanto Yuono, SE Ns Harmilah, M.Kep, Sp.MB Members
1. Secretariat :
1. Dasilah
2. Evriyani, Amd
3. Eva Lidya Yunita, AMd.Kg
4. Astuti Dwi E, Amd
5. Veronica Anindyati Nugroho Putri, Amd
2. Scientific committee :
1. Hesty Widyasih, SSiT, M.Keb (keynote speaker+materials)
2. Achmad Husein, SKM, MPd
3. Sugeng, Ners.,M.Sc
4. Almira Sitasari, S.Gz, MPH
5. Aryani Widayati, SSiT.,MPH
6. Eni Kurniati, S.SI.,M.Sc Sabar Santosa, SPd, APP, M.Kes
3. Proceeding commitee : 1.
2. Dr. drg. Wiworo Haryani, M.Kes.
3. Siti Nuryani, S.Si.,M.Sc 4. Dr. Ir. I Made Alit Gunawan, M.Si.
5. Niken Meilani, SSiT,SPd, M.Kes
6. Ns.Sutejo, M.Kep.Sp.Kep.J
7. Dr. drg. Quroti Ayun, M.Kes
8. Muryoto, SKM.,M.Kes 9. Ayu Triani, S.T.
10. Desi Rochmawati, SS.M,Hum
11. Andika Trisurini, S.Pd
12. Dina fadhilah, S.Tr
13. Apriyatni Condro Ekarini, S.SiT.,M.Kes
14. Sapto Harmoko, SIP
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4. Event Committee :
1. Yanuar Amin, S.ST.,SH
2. Rosa Delima Ekwantini, S.Kp.,M.Kes
3. Dra. Elza Ismail, M.Kes 4. Abdul Majid, S.Kep. Ns.M.Kep.
5. Sarka Ade, SIP, S.Kep. MA
6. Rybob Khomes, S.Kom
5. Promotion, Publication and :
1. Ika Prasetyo Nugroho, SE Bussiness Committee
2. Uki Wulanggita, SST
3. Nugraheni Tri Lestari, SKM, MPH
4. Mina Yumei Santi, SST., M.Kes
5. Etty Yuniarly, SST.,MPH
6. Haryono, SKM.,M.Kes
7. Trubus Basuki, AMd
8. Bekti Irianto
6. Registration :
1. Drs. Harya Kunjana
2. Narto, BE., STP.,MP
3. Siti Hani Istiqomah, SKM.,M.Kes
4. Nuriana Kartika Sari, SST
5. Suhardjono, S.Pd.,S.SiT.,M.Kes
7. Logistics
1. Tjarono Sari, SKM.,M.Kes
2 Puti Sudarwati, S.Si
3. Sukarti, SIP
8. Decoration , Place :
1. Suharyana, SKM
2. Purwanto
9. Documentation :
1. Heri Purwanto, SE 2. Harsono, AMd.
3. Abdul Hadi Kadarusno, SKM.,MPH
10. Transportation :
1. Tri Widodo, AMd
2 Agus Pamuji
3. Giyanto
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Oral Presentation
O-06
FACTORS RELATED TO BREAST CANCER AMONG WOMEN IN YOGYAKARTA
CITY PUBLIC HOSPITAL, INDONESIA
1 Tia Arsittasari, Dwiana Estiwidani, Nanik Setiyawati Midwifery Department of Health
Polytechnic of Health Ministry Yogyakarta, Indonesia E-mail:
ABSTRACT
Breast cancer is a dangerous tumor which attacks the breast tissue and also the second largest cause cancer related deaths among women. In 2013, Yogyakarta became the province which had the highest prevalence about 2,4%. The data from the Health Minister of Yogyakarta showed that many cases of breast cancer happened to women and keep increasing from year to year in Yogyakarta Province. The purpose of this study was to find out the factors related to breast cancer among women in Yogyakarta City Public Hospital, Indonesia. This study was an analytical observational research with cross sectional design. The samples were collected by using purposive sampling with 94 respondents. The data were collected by using primer and secondary data with data collection technique. The data analysis was carried out by using Chi-Square Test. The result of the study showed that the factors which were related to breast cancer cases were age (p- value = 0,005), menarche age (p-value = 0,019), history of breastfeeding (p-value = 0,008), history of using hormonal birth control (p-value = 0,019) and genetical factor (p- value = 0,014). The conclusion of the study was that the factors which were related to breast cancer cases were age, menarche age, history of breastfeeding, history of using hormonal birth control and genetical factor.
Keywords : Breast Cancer, Age
INTRODUCTION
Cancer is one of the major causes of morbidity and mortality worldwide. According to the World Health Organization (WHO), in 2012 estimates there were 14 million new
1
cancer cases and 8.2 million (58.57%) deaths from cancer. According to data from the Global Cancer Burden in the International Agency for Research on Cancer (IARC) in 2012 breast cancer was a disease with the highest percentage of new cases of cancer (after controlled by age), amounting to 43.3%, and the percentage of deaths (after controlled by age) from breast cancer by 12.9%. Breast cancer was one of the cancers with the highest prevalence in Indonesia in 2013, amounting to 0.5%. Yogyakarta province was a province
2 that has the highest prevalence of breast cancer, which amounted to 2.4%.
Breast cancer is currently the second leading cause of death from cancer in women, after cervical cancer and is the most common cancer among them. Breast cancer
3
could spread significantly and often do not cause symptoms. Breast cancer was a malignant tumor that attacks the breast tissue. Breast cancer prognosis depended on the growth rate. From the observation, most breast cancer patients already could not be
4 helped because of late unrecognized and untreated.
According to Yogyakarta health office, in January 2017, the data obtained on Breast Cancer Cases between 2013 and 2016 in the province, there was yearly increase in cases. Based on gender, 99% more common in women. Based on the age group, many breast cancer cases occur in the age group 45-64 years.5 According to the City Health Office Yogyakarta in January 2017, the data obtained Communicable Diseases
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43 Surveillance Integrated Health Center Year 2013-2016 in the city of Yogyakarta saw an
6 annual increase in cases of breast cancer.
Risk factors for breast cancer include age, reproductive factors (menarche age, early first pregnancy at an advanced age, low parity, lactation), endocrine factors (oral contraceptives, hormone replacement therapy, age > 75 years, with the density of the breast 75%, atypical hyperplasia), diet (consumption of alcohol, obesity) and genetic /
3 family history (family members with breast cancer, family history of ovarian cancer).
The results showed factors associated with the incidence of breast cancer are
7
obesity, age of first birth, history of breastfeeding, and menarche age. The risk factors that influence breast cancer incidence are menarche age, age of first birth, parity, history
8 of breastfeeding, history of using hormonal birth control and family history of disease.
The highest proportion of breast cancer patients are aged> 40 years, female, married and
9
stage III. Of the 92 respondents who have breast cancer have breast cancer 92.4%> 30 years, 90.2% of respondents the number of children who have breast cancer 1-3 children,
10 67% menarche age <10 years and 44,% suffer from breast cancer III.
Based on the results of preliminary studies conducted in Yogyakarta City Public Hospital in February 2017, the data obtained Number of Cases Inpatient and Outpatient Case Breast Cancer Year 2013-2016 for the years of 2013 there were 223 cases, in 2014 there were 287 cases, in 2015 there were 190 cases and in 2016 there were 248 cases.
Based on these data, the study was conducted to factors related to breast cancer among women in Yogyakarta City Public Hospital, Indonesia.
METHOD
This study was conducted in Yogyakarta City Public Hospital in May 2017. This research is an observational analytic research using a cross-sectional design. The study population was all married women patients diagnosed with breast cancer at the Yogyakarta City Public Hospital in 2016 totaling 248. The sample was a married woman with breast cancer who meet the criteria in Yogyakarta City Public Hospital in 2016 who meet the inclusion and exclusion criteria. The sample size in this study were 94 respondents. Sampling of the population that is done by purposive sampling. The independent variables in this study were age, age of menarche, parity, history of breastfeeding, history of using hormonal birth control and family history. The dependent variable in this study were breast cancer. The data were collected by using primer and secondary data with data collection technique. The data analysis was carried out by using Chi-Square Test.
RESULTS
This study used secondary and primary data to the 94 respondents, using technique purposive sampling. Results of research conducted as follows:
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1. Univariate Analysis
Table 1. Characteristics of Respondents No. Factors Frequency %
1 Breast Cancer Stage IV
5
5.3 Stage III
50
53.2 Stage II
27
28.7 Stage I
12
12.8 Total 94 100
2 Age Risk
76
80.9 No Risk
18
19.1 Total 94 100
3 Menarche Age Risk
49
52.1 No Risk
45
47.9 Total 94 100
4 Parity Risk
13
13.8 No Risk
81
86.2 Total 94 100
5 History of Breastfeeding Risk
52
55.3 No Risk
42
44.7 Total 94 100
6 History of Using Hormonal Birth Control Risk
60
63.8 No Risk
34
36.2 Total 94 100
7 Family History Risk
28
29.8 No Risk
66
70.2 Total 94 100
Source: Secondary Data Yogyakarta City Public Hospital in 2016 and Primary
Based on table 1 data showed that the majority of respondents breast cancer patients with stage III of 50 respondents (53.2%), age risk (≥ 40 years) by 76 respondents (80 , 9%), menarche age risk (<12 years) with 49 respondents (52.1%), Parity no risk (P≥1) of 81 respondents (86.2%), history of breastfeeding risk (P0, P≥1 never breastfeeding) of 52 respondents (55.3%), history of using hormonal birth c ontrol risk (using hormonal birth control ≥ 5 years in a row) 60 respondents (63.8%) and family history no risk (no history of cancer) were 66 respondents (70.2%).
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2. Bivariate analysis
Table 2. Bivariate Analysis
Breast Cancer Total p- No. FactorsIV III
II I value f % f % f % f % f %
1 Age Risk 5 6,6 42 40,2 24 31,6 5 6,6 76 100 No-Risk 0 0 8 44,4 3 16,7 7 38,9 18 100 0,005 Total 5 5,3 50 53,2 27 28,7 12 12,8 94 100
2 Menarche Age Risk 1 2 30 61,3 15 30,6 3 6,1 49 100 No-Risk 4 8,9 20 44,4 12 26,7 9 20 45 100 0,019 Total 5 5,3 50 53,2 27 28,7 12 12,8 94 100
3 Parity Risk 1 7,7 4 30,8 6 46,2 2 15,4 13 100 No Risk 4 4,9 46 56,8 21 25,9 10 12,3 81 100 0,354 Total 5 5,3 50 53,2 27 28,7 12 12,8 94 100
4 History of Breastfeeding Risk 5 9,6 24 46,2 13 25 10 19,2 52 100 No Risk 0 0 26 61,9 14 33,3 2 4,8 42 100 0,008 Total 5 5,3 50 53,2 27 28,7 12 12,8 94 100
5 History of Using Hormonal Birth Control Risk 2 3,3 39 65 14 23,3 5 8,3 60 100 No-Risk 3 8,8 11 32,4 13 38,2 7 20,6 34 100 0,019 Total 5 5,3 50 53,2 27 28,7 12 12,8 94 100
6 Family History Risk 4 14,3 18 64,3 4 14,3 2 7,1 28 100 Tid ak Risk 1 1,5 32 48,5 23 34,8 10 15,2 66 100 0,014 Total 5 5,3 50 53,2 27 28,7 12 12,8 94 100
Based on table 2 data showed that the results of Chi-square test breast cancer by the age variable obtained p-value = 0.005 (p <0.05), we can infer that there is a relationship between age and breast cancer. In the variables of menarche age obtained p-value = 0.019 (p <0.05), meaning that there is a relationship between the menarche age with breast cancer. Meanwhile, in the variables of parity obtained p- value = 0.354 (p> 0.05), it means that there is no relationship between parity with breast cancer. The variables of history of breastfeeding obtained p-value = 0.008 (p <0.05), proves that there is a relationship between breastfeeding and breast cancer history. While in the variables of history of using hormonal birth control obtained p- value = 0.019 (p <0.05), we can conclude that there is a relationship between a history of using hormonal birth control and breast cancer. In the variables of family history variables obtained p-value = 0.014 (p <0.05), meaning that there is a relationship between a family history of breast cancer.
DISCUSSION
1. Breast Cancer The results showed that the highest proportion of breast cancer in any related factors are at stage III. This is consistent with previous studies that show that the
9
highest proportion of breast cancer patients are stage III (49.0%). Other previous study showed that patients with stage III occupy a percentage of 68.8% of the total
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cases. Other previous studies showed that most who have stage III breast cancer
10
by as many as 41 respondents (44.0%).The majority of breast cancer patients come to the hospital for a check-up in stage
10 III. This is because in the early stages of breast cancer, usually the patient does not feel
pain or no signs at all. In the event of disruption of the breast, a woman initially paid little
9 attention until the situation becomes serious. The highest proportion of stage III shows that a lack of information and awareness of the respondents for breast cancer early
12 detection and treatment of the first symptoms is still very low.
2. Age The results showed that the majority of respondents with age risk of breast cancer patients (≥ 40 years) by 76 respondents (80.9%). There is a relationship between age and the incidence of breast cancer (p-value = 0.005). This is consistent with results of previous studies that showed an increased risk of breast cancer at the age of 35-44 years (OR = 3.370; 95% CI = 1.390 to 8.170) and 45-54 years (OR =
13
3.690; 95% CI = 1.558 to 8.739 ). There are differences in the proportion of aged
9 patients with breast cancer based on clinical stage (p = 0.015).
Breast cancer incidence increases rapidly at reproductive age and thereafter
3
increased at a lower rate. Increasingly aged woman, the greater the likelihood of developing breast cancer. Age women are more often affected by breast cancer are over the age of 40 years. However, it does not mean women under 40 years of age
14
may not be affected by breast cancer, only it happened more frequently. The average age of 40 (± 5) years, the ovaries of women is less receptive to the effects of FSH and LH. The effect of estrogen secretion decreases and fluctuates, so that became more frequent anovulatory menstrual disorders that cause some women in
15 the years before menopause.
3. Menarche Age The results showed that the majority of respondents with menarche age risk of breast cancer patients (<12 years) with 49 respondents (52.1%). There is a relationship between the menarche age with the incidence of breast cancer (p-value = 0.019). This is consistent with results of previous studies that showed that the menarche age <12 years (p = 0.031; OR = 3.492) had a significant relationship to the
16
incidence of breast cancer in women. Age menarche early(<12 years) (OR = 2.638,
8
95% CI = 0.735 to 9.466) heightens the risk of breast cancer incidence. Menarche age <12 years associated with the incidence of breast cancer (p = 0.001; OR = 4.41;
17 95% CI: 1.33 to 14.63).
Menarche early or first menstruation at a relatively young age (<12 years) was associated with an increased risk of breast cancer.age menarche Earlylead to exposure to the hormone estrogen becomes faster so that it can trigger the growth of
3
cells in certain body parts are not normal. menstrual early age associated with the duration of exposure to the hormones estrogen and progesterone in women that
14 affects the tissues including breast tissue proliferation.
4. Parity The results showed that the majority of respondents with parity no risk of breast cancer patients (P≥1) of 81 respondents (86.2%). There was no relationship between parity with the incidence of breast cancer (p-value = 0.354). This is not in accordance with the results of previous studies showing that parity nulliparous (OR =
8 4.353, 95% CI = 0.463 to 40.898) heightens the risk of breast cancer incidence.
Nulliparitas can increase the risk of developing breast cancer because of longer exposure to the hormone estrogen. High levels of the hormone estrogen during reproductive years of a woman, especially if it is not interrupted by hormonal
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47 changes in pregnancy, increasing the chances of growth of cells that are genetically
15
damaged and cause cancer. nulliparous woman had 4.0 times greater risk than
14
multiparous women for breast cancer (RR = 4.0). The difference in the results is due to differing criteria taken responder affected and not affected by breast cancer; and for respondents with fewer parity nulliparous (13.8%) of the multiparous (86.2%), so that the incidence of breast cancer in this study may be caused by factors other than parity.
5. History of Breastfeeding The results showed that the majority of respondents with history of breastfeeding risk of breast cancer patients (P0, P≥1 never breastfeeding) of 52 respondents (55.3%). There is a relationship between History of breastfeeding with the incidence of breast cancer (p-value = 0.008). This is consistent with results of previous studies that showed that a history of breastfeeding <4 months (p = 0.00; OR
7
= 5.49; CI = 2.05 to 14.74) can increase the risk of breast cancer. History is not breastfeeding (OR = 2.11; 95% CI = 0.364 to 12.320) heightens the risk of breast
8
cancer incidence. Mothers who do not breastfeed associated with the incidence of
17 breast cancer (the p = 0.002; OR = 4.24; 95% CI: 1.22 to 14.76).
Women who are breastfeeding lowers cancer compared to women who did not breastfeed. The longer the period of breastfeeding, the greater the protective effect against cancer exists. This is due to a decrease in estrogen levels and secretion of
3
carcinogenic substances during breastfeeding. Time breastfeed longer have a more positive effect in lowering the risk of breast cancer in which there is a decrease in
8 estrogen and materials expenditure trigger cancer during breast feeding.
Breastfeeding does not protect women from breast cancer but affects levels of
7 estrogen in a woman's body.
6. History of Using Hormonal Birth Control The results showed that the majority of respondents with history of using hormonal birth control risk of breast cancer patients (using hormonal birth control ≥ 5 years in a row) 60 respondents (63.8%). There is a relationship between a history of using hormonal birth control with the incidence of breast cancer (p-value = 0.019).
This is consistent with results of previous studies showing that the use of hormonal co ntraception ≥ 5 years (p = 0.028; OR = 3.266) had a significant relationship to the
16
incidence of breast cancer in women. The use of hormonal contraceptives is a risk
18 factor for breast cancer (OR = 1.146).
Oral contraceptives role in increasing the risk of breast cancer in
3
premenopausal women. Women who use oral contraceptives at high risk for breast cancer. The content of estrogen and progesterone in oral contraceptives would give
14
the effect of excessive proliferation in the mammary gland. The use of oral contraceptives in the long term (> 5 years) cause the risk of developing breast cancer
4
is on the rise. The use of hormonal contraceptives may cause increased exposure to estrogen in the body that can trigger abnormal cell growth in certain parts, such as
16 the breast.
7. Family History The results showed that the majority of respondents with family history no risk of breast cancer patients (no history of cancer) were 66 respondents (70.2%). There is a relationship between a family history of breast cancer (p-value = 0.014). This is consistent with results of previous studies indicating that family history (OR = 6.938,
8
95% CI = 0.793 to 60.714) heightens the risk of breast cancer incidence. A family history of breast cancer increases the risk of breast cancer with OR = 8 (95% CI:
19 1.839 to 34.794).
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3 History of cancer in the family is one of the risk factors of breast cancer. The most common risk factor is a history of breast cancer experienced by first-degree relatives of
15 the mother. One of the main reasons for this risk is an inherited mutation in one of two
14 genes, namely BRCA1 and BRCA2. Family history is an important component in the history of the patient to be implemented screening for breast cancer. There is an increased risk of malignancy in women whose families have breast cancer, the presence
8 of mutations in several genes (BRCA1 and BRCA2).
CONCLUSIONS
Patients with breast cancer in Yogyakarta City Public Hospital in 2016 the majority of respondents breast cancer patients with stage III, age risk, menarche age risk, parity no risk, history of breastfeeding risk, history of using hormonal birth control risk and family history no risk. There is a relationship between the age, menarche age, history of breastfeeding, history of using hormonal birth control and family history of breast cancer occurrence. There was no association between parity with the incidence of breast cancer.
RECOMMENDATION
This study may provide information to health workers, especially midwives about the factors associated with the incidence of breast cancer such as age, menarche age, history of breastfeeding, history of using birth control hormonal and family history so that it can seek to improve health promotion and implementation of the BSE as early detection breast cancer in women and extension factors associated with the incidence of breast cancer, such as breast-feeding her baby at least 6 months and hormonal contraceptive use with the incidence of breast cancer. For further research this study may make reference, should use the study design case-control and by taking samples in larger quantities.
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